Unit SYSTEMIC PATHOLOGY VI

GASTROENTEROLOGY - MOD. 1

Code	GP005773
Location	PERUGIA
CFU	1
Teacher	Stefano Fiorucci
Teachers	Stefano Fiorucci Emanuel Cavazzoni (Codocenza)
Hours	7 ore - Stefano Fiorucci 5 ore (Codocenza) - Emanuel Cavazzoni
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Digestive and hepatic pathophysiology. Diagnosis and Therapy. Elements of physiopathology, clinic, diagnostics and therapy of diseases of the digestive system. Clinical and instrumental approach to diseases of the digestive system.
Reference texts	Harrison’s Principles of Internal Medicine 19 Edizione
Educational objectives	To learn the principles of digestive physiopathology and of the pharmacological and dietary treatment of diseases of the digestive system.
Prerequisites	Nowledge of the principles of digestive anatomy and general pathology
Teaching methods	Frontal lessons
Other information	CONTACTS: 075/58558120 Bagainti.chiara@gmail.com Stefano.fiorucci@unipg.it The professor Fiorucci receives, by appointment, every day from 13 to 14. For information on teaching and lessons, consult the website: gastroenterologia.unipg.it
Learning verification modality	oral examination
Extended program	Symptoms and signs of diseases of the digestive system. Approach to the patient with dysphagia. Approach to the patient with nausea and vomiting. Approach to the patient with gastrointestinal hemorrhages. Esophageal diseases. Disorders of the esophagus motility. GE reflux disease and complications. Neoplasms of the esophagus Diseases of the stomach. H. pylori infection Adverse affects of NSAIDs and ASAs. Peptic ulcer. Acute and chronic gastritis. Gastric neoplasms Approach the patient with diarrhea and constipation Malabsorption syndrome. Food intolerances and allergies. Celiac disease. Functional syndromes of the digestive system. Chronic and intestinal inflammatory diseases. Crohn's disease. Chronic and intestinal inflammatory diseases. Ulcerative rectocolitis. Colon polyps Colon and rectal cancer. Approach the patient with diseases of the pancreas. Acute pancreatitis Chronic pancreatitis. Neoplasms of the pancreas Evaluation of liver function. Approach the patient with acute and chronic liver diseases. Bilirubin metabolism disorders. Jaundice and cholestasis. Alcoholic and non-alcoholic liver disease (NASH) Acute and chronic viral hepatitis HADES PRACTICAL APPROACH TO THE PATIENT WITH DIGESTIVE HEMORRAGE Acute and chronic viral hepatitis Autoimmune diseases of the liver (PBC, PSC, autoimmune hepatitis) Liver cirrhosis and complications Hepatocellular carcinoma Acute pancreatitis Calculations of biliary tract and complications. Cholangiocarcinoma. Liver transplantation

GASTROENTEROLOGY - MOD. 2

Code	GP005774
Location	PERUGIA
CFU	1
Teacher	Monia Baldoni
Teachers	Monia Baldoni
Hours	12 ore - Monia Baldoni
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

GASTROENTEROLOGY - MOD. 3

Code	GP005775
Location	PERUGIA
CFU	1
Teacher	Patrizia Ricci
Teachers	Patrizia Ricci
Hours	10 ore - Patrizia Ricci
Learning activities	Caratterizzante
Area	Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

MEDICAL ONCOLOGY

Code	GP004715
Location	PERUGIA
CFU	2
Teacher	Fausto Roila
Teachers	Fausto Roila
Hours	24 ore - Fausto Roila
Learning activities	Caratterizzante
Area	Clinica delle specialità medico-chirurgiche
Academic discipline	MED/06
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Epidemiology, primary prevention, early diagnosis of malignant neoplasia. Risk factors, natural history, histology, symptoms, diagnosis, stadiation and treatment of the 13 most important malignant neoplasia. Prevention and treatment of cancer symptoms and adverse events induced by antineoplastic treatments. Communication, ethics in the practice and in clinical research in oncology and conflict of interests.
Reference texts	1. Manuale di oncologia medica a cura del COMU (Collegio degli Oncologi Medici Italiani), edizioni Minerva Medica; 2. DeVita, Helmann, and Rosenberg. Cancer. Principles & practice of oncology. Wolters Kluwer editors. 3. Linee Guida dell’Associazione Italiana di Oncologia Medica (AIOM) 2019.
Educational objectives	Learn the indispensable notions for a correct approach to the neoplastic patient both from a scientific and humanistic point of view.
Prerequisites	Knowledge of basic internal medicine, knowledge of pharmacology, medical genetics, radiology and generale principles of ethics in medicine.
Teaching methods	face to face lessons.
Learning verification modality	oral examination.
Extended program	- Epidemiology of tumors - Ethical problems in the oncology clinical practice and in the clinical research - Conflict of interests in medical oncology. - Communication with the oncological patient and its family - How to read the results of a clinical trial in oncology - Approval and reimbursement of the new antineoplastic agents - Definition, interventions and training in psycho-oncology - Breast cancer - Prostatic cancer - Lung cancer - Colo-rectal cancer - Melanoma - Ovarian cancer - Gastric cancer - Pancreatic cancer - Kidney cancer - Bladder cancer - Testicular cancer - Brain tumors - Sarcoma - Screening of the cervical cancer - Screening of familiar hereditary cancers - Oncological emergencies - Prevention of skeletal events in patients with bone metastases - Prevention and treatment of adverse events of the aromatase inhibitors - Adverse events of immune checkpoint inhibitors - Differences between supportive therapy and palliative care - Tumor symptoms and adverse effects of antineoplastic agents (cancer pain, cough, dyspnea, anorexia-cachexia, neoplastic fever, nausea and vomiting, diarrhea, constipation, thromboembolic events, febrile neutropenia).

PROFESSIONALISING TRAINING IN GASTROENTEROLOGY

Code	GP005777
Location	PERUGIA
CFU	1
Teacher	Stefano Fiorucci
Teachers	Stefano Fiorucci
Hours	25 ore - Stefano Fiorucci
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/12
Type of study-unit	Obbligatorio (Required)

PROFESSIONALISING TRAINING IN MEDICAL ONCOLOGY

Code	GP004714
Location	PERUGIA
CFU	1
Teacher	Fausto Roila
Teachers	Fausto Roila
Hours	25 ore - Fausto Roila
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/06
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Clinical practice in medical oncology: collection of the oncological history, physical examination in the oncological patient, definition of the diagnostic-therapeutic strategy and adequate communication to the patient.
Reference texts	1. Manuale di oncologia medica a cura del COMU (Collegio degli Oncologi Medici Italiani), edizioni Minerva Medica; 2. DeVita, Helmann, and Rosenberg. Cancer. Principles & practice of oncology. Wolters Kluwer editors. 3. Linee Guida dell’Associazione Italiana di Oncologia Medica (AIOM) 2019.
Educational objectives	Knowledge of malignant neoplasia in clinical practice for a correct approach to the neoplastic patients both from a scientific and humanistic point of view.
Prerequisites	Knowledge of basic internal medicine, pharmacology, radiology, surgery, radiotherapy and general principles of ethics in medicine.
Teaching methods	clinical activity with inpatients and outpatients supported by the tutors (learning by job).
Learning verification modality	Direct check by the tutor of the ability to collect an anamnesis, make an objective examination and discuss the diagnostic-therapeutic options.
Extended program	- Oncological anamnesis collection - Physical examination of the cancer patient -Oncological evaluation at multidisciplinary team - Radiological evaluation during the follow up - Appropriate use of tumor markers - Discussion of the principal treatment protocols - Practical principles of supportive therapies and palliative care - Practical principles to a correct communication in oncology - Management of the emergencies in oncology.

PROFESSIONALISING TRAINING IN UROLOGY

Code	GP005776
Location	PERUGIA
CFU	1
Teacher	Michele Del Zingaro
Teachers	Michele Del Zingaro
Hours	25 ore - Michele Del Zingaro
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)

UROLOGY - MOD. 1

Code	GP004712
Location	PERUGIA
CFU	2
Teacher	Ettore Mearini
Teachers	Ettore Mearini
Hours	24 ore - Ettore Mearini
Learning activities	Caratterizzante
Area	Discipline ostetrico-ginecologiche, medicina della riproduzione e sessuologia medica
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Glossary and urologic semeiotics; hematuria; urinary obstructive syndrome; malformations of the urinary system; Urinary lithiasis; benign prostatic hyperplasia; urinary infections; urologic oncology; urologic disease in the elderly; neurogenic bladder; andrology.
Reference texts	-Trattato di Medina Interna- Malattie del rene, delle vie urinarie e dell'apparato genitale maschile. Autori: Albertazzi-Porena. Editore PICCIN- Materiale audiovisivo presentato durante le lezioni del Corso -Trattato di Medina Interna- Malattie del rene, delle vie urinarie e dell'apparato genitale maschile. Autori: Albertazzi-Porena. Editore PICCIN Audiovisual material presented during course
Educational objectives	OBJECTIVES OF KNOWLEDGE (Knowledge) To acquire the basic knowledge about the epidemiology, prevention, pathogenesis, the clinical presentation, clinical and instrumental diagnosis, pharmacologic therapy and surgical strategy of the main diseases of urinary tract and male genitalia. OBJECTIVES OF INTERACTIVE EDUCATION The interactive teaching will be carried out in order to transmit the students a methodological approach to the nursing management of the main conditions concerning urologic and andrological disease. Objective will be to develop the ability to recognize the signs and symptoms of various diseases and their clinical value in order to be able to improve nursing management of the patient. ABILITIES (skills) The following abilities are considered preliminary and acquired: • to collect accurately medical history and symptoms of the patients • to know the most common laboratory tests, to identify major alterations of biochemical profile and to understand their clinical significance • the main maneuvers of general physical examination (inspection, palpation, percussion and auscultation of the chest and abdomen). Aims of gestural skills include: -Positioning of different types of catheters -management of urostomies -nursing in diagnostic urologic exam (uroflowmetry, transrectal ultrasound, ultrasound of the urinary tract, scrotal ultrasound, urodynamic examination, urethrocystoscopy, cystography) -nursing in ESWL -nursing in patient undergoing urologic surgery For this purpose hands-on training will be organized for the management of urinary catheter and urostomy. OBJECTIVES OF RELATIONAL EDUCATION (interpersonal skills) The objectives are to transmit students the value of the relationship between nurse and patient, highlighting the ethical and psychological aspects; another aim will be to make the student able to evaluate the psychological, sociological and cultural aspects of the patient in order to adapt the language and improve the understanding of the interview. We will also provide the main tools to properly train the care-giver figure. At the end of the course students will have the theoretical and practical bases for proper nursing management of the urologic and andrological patient.
Prerequisites	Knowledge of the anatomy and physiology of the urinary and male genital system are indispensable in order to understand the topics of the lessons. Fundamentals of pharmacology and oncology seem very useful to achieve the objectives of the interdisciplinary course.
Teaching methods	Seminar lectures with audiovisual materialPresentation of clinical cases. Presentations of video about the main surgical strategies - Monothematic seminars
Other information	Attendance Mandatory. At least 60% of lessons
Learning verification modality	The assessment includes final written and oral exam. The final valutation of the student’s "knowledge" consists of a written exam with closed stimulation and closed answer, in preparation for the oral examination. The written exam consists of 15 multiple choice and has a maximum duration of 20 minutes. Each correct answer has a score of 2. Access to the oral test is allowed for scores equal to or upper than 18. The final oral exam is characterized by an open stimulation with open answer; it consists of two questions and has a duration lower than 15 minutes. The final vote is in 30/30.
Extended program	-Introduction to urological glossary -Semeiotics of Kidney, urinary tract and the male genitalia -Vesical catheter: classifications, main types of urinary catheter, clinical indications, complications. - Fundamentals of urinary tract and male reproductive malformation focusing on epidemiology, etiology, clinical features, diagnosis, therapy. -Upper and lower urinary tract obstruction: etiology, pathogenesis, clinical features, diagnosis and therapy. - Upper urinary tract disease: epidemiology, etiology, clinical features, diagnosis, pharmacologic therapy and surgery of stenosis of pelvis-ureter junction and ureteral stenosis. -Benign prostatic hyperplasia: epidemiology, etiology, molecular biology and pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery. -Hematuria: etiology, diagnostic and therapeutic work-up. -Prostate cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, PSA and new markers, pharmacologic therapy and surgery. -Kidney cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery. -Bladder cancer: epidemiology, etiology, fundamentals of pathogenesis and genomics, clinical features, diagnosis, pharmacologic therapy and surgery. -Urinary derivations and their management -Testicular cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of chemotherapy and surgery. -Penis cancer: epidemiology, etiology, pathogenesis, clinical presentation, diagnosis, fundamentals of surgery and radiotherapy. -Urinary Tract Infections: epidemiology, etiology, pathogenesis, diagnosis, pharmacologic therapy, management of complications. -Litiasi Urinary: epidemiology, etiology, pathogenesis, clinical features, diagnosis, pharmacologic therapy, water therapy, dietary, physical therapy and surgery. -Neuromuscolar dysfunction of bladder: main etiological factors, pathogenesis, clinical presentation, diagnosis and principles of pharmacologic therapy and rehabilitation. -Urinary incontinence: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, pharmacologic therapy and surgery. -Genitourinary prolapse: epidemiology, classification, etiology, pathogenesis, clinical presentation, diagnosis, rehabilitation therapy and surgery. - Minimally invasive surgery: indications, advantages and disadvantages, applications in urology We will also present the main issues about surgical andrology concerning infertility and sexual dysfunction. The concepts of anatomy and physiology of the male genitalia will be necessary to evaluate the morphological aberrations (congenital and acquired penile curvature), functional (erectile dysfunction and priapism). Acute scrotum (testicular torsion and orchi-epididymitis), cryptorchidism, varicocele will be debated both as individual disease and as a clinical entity related to male infertility, paying particular attention to their prevention. Since 30% of population is involved by an urological or andrological disease, we will highlighted the role of these diseases in determining a worsening of the quality of life of the individual and the couple; we will emphasize the importance of suitable management of urological and andrological disease also for the significant impact on the social and financial costs.

UROLOGY - MOD. 2

Code	GP004713
Location	PERUGIA
CFU	1
Teacher	Giovanni Cochetti
Teachers	Giovanni Cochetti
Hours	12 ore - Giovanni Cochetti
Learning activities	Caratterizzante
Area	Discipline ostetrico-ginecologiche, medicina della riproduzione e sessuologia medica
Academic discipline	MED/24
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian